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KROGER DRUG STORE #499
CH041190 BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
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Covered Entity Details
Entity Name
BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
Subdivision Name
RUTH P. FIELD MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH041190
Entity Address
719 N Okatie Hwy
Ridgeland, SC 29936-8276
Grant Number
H80CS00699
Participating Start Date
12/1/1992
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
KROGER DRUG STORE #499
Pharmacy Address
125 TOWNE DRIVE
BLUFFTON, SC 29910
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/14/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Roland J Gardner, CEO
(843) 987-7448 Ext: 7448
Contract Pharmacy Representative
Krogers
Anastacia Frey, Senior Manager
(513) 698-1875
Signed By Date
7/12/2019
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